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Fetal Medicine Posters
Audit of management of gestational diabetes in pregnancy
  1. N Deole,
  2. K Barber,
  3. P Dyer
  1. Heartlands Hospital, Birmingham, United Kingdom

Abstract

Aims and objectives We aimed to audit the management and maternal and fetal outcomes of women with gestational diabetes.

Methods We did a retrospective collection of data from all women with gestational diabetes who delivered between 1st January 2010 and 30th June 2010. Data was collected from electronic databases and clinical notes. Diagnosis of GDM was made using WHO GTT either in the index pregnancy or a previously affected pregnancy. Women with HbA1c <6.1 throughout pregnancy were considered as having good control and women with last HbA1c> 6.1 were said to have suboptimal control.

Results A total of 154 women with gestational diabetes delivered in the above period. Of these 114 (73%) were newly diagnosed GDM. Overall incidence of macrosomia was 5% for birthweight > 4kg. Three (2%) of the babies had shoulder dystocia at birth with no neonatal injuries. Three (2%) babies were admitted with neonatal hypoglycemia. The incidence of preeclampsia and other hypertensive disorders was 7%. There were no maternal or neonatal deaths in this cohort.

Women with suboptimal control had a statistically significant increase in birth weight greater than 4kg [OR-0.15 (0.03,0.76)], however no difference was found in other maternal and neonatal outcomes when compared with women with good control.

At postnatal follow up, 1% of the women had overt diabetes and 2% had impaired GTT.

Conclusion Only 60% of GDM achieved good glycaemic (based on HbA1C). The only significant outcome in suboptimally controlled women was birthweight > 4kg. 55% women with GDM were controlled with diet alone.

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